A comprehensive look at the rising epidemic of eating disorders among youth, exploring causes, treatments, and pathways to recovery
Imagine a 14-year-old girl, let's call her Melissa, who has lost 8 kg in six months. Her resting heart rate drops to 56 beats per minute, her blood pressure becomes dangerously low, and she misses her periods for months.
She claims she's "just eating healthy" but becomes angry when her parents encourage her to eat more. This isn't a phase or typical teenage behavior—this is an eating disorder, a serious mental health condition that's becoming increasingly common among children and adolescents 2 .
When most people think of eating disorders, they picture extreme thinness or secretive vomiting. But the reality is far more complex. Eating disorders in children and adolescents encompass a range of conditions, each with distinct characteristics.
Characterized by an intense fear of gaining weight, distorted body image, and persistent food restriction leading to significantly low body weight 3 .
Marked by recurrent binge-eating episodes followed by compensatory behaviors such as vomiting, excessive exercise, or laxative misuse 3 .
Similar to BN in its binge-eating component but without compensatory behaviors. Driven by dysregulated reward system, emotional distress, and impaired impulse control 3 .
Characterized by extreme food avoidance without the body image disturbances typical of AN or BN. Driven by sensory sensitivities or fears of choking 3 .
| Disorder | Key Features | Physical Consequences | Diagnostic Challenges |
|---|---|---|---|
| Anorexia Nervosa | Fear of weight gain, restriction, body image distortion | Stunted growth, osteoporosis, cardiac issues, amenorrhea | Younger children may not express body image concerns |
| Bulimia Nervosa | Binge-eating with compensatory behaviors | Electrolyte imbalances, dental erosion, cardiac arrhythmias | Often hidden from parents and providers |
| Binge-Eating Disorder | Binge-eating without compensation | Weight gain, metabolic syndrome, cardiovascular issues | Often mistaken for simple overeating |
| ARFID | Food avoidance without body image issues | Malnutrition, developmental delays, growth impairment | Often misdiagnosed as picky eating |
Eating disorders don't have a single cause but rather emerge from a complex interplay of biological, psychological, and social factors. Recent years have seen a dramatic increase in cases, particularly since the COVID-19 pandemic 4 .
Research suggests that certain individuals may have a genetic predisposition to eating disorders. Neurobiological studies indicate differences in brain structure and function, particularly in areas related to reward processing and impulse control 3 .
Certain personality traits—such as perfectionism, anxiety, and obsessive-compulsive tendencies—can increase vulnerability. Many children with eating disorders also struggle with comorbid conditions like depression, anxiety disorders, and ADHD 3 .
The impact of social media cannot be overstated. Today's youth have unprecedented access to content glamorizing fad diets, weight loss, and specific body types. This constant exposure can lead to what experts call "orthorexia" 4 .
Current research emphasizes that family factors can both protect against and contribute to eating disorder risk. Bowen's Family Systems Theory suggests that patterns like differentiation of self play important roles in adolescent development .
For decades, treatment for eating disorders focused primarily on individual therapy, often with limited success. Then came a paradigm shift: Family-Based Treatment (FBT), also known as the Maudsley approach 2 .
FBT takes a non-blaming approach to eating disorders and focuses on empowering and engaging parents in the refeeding process. The method emphasizes early restoration of weight and nutrition, and resumption of regular meal patterns and eating habits 2 .
Parents take charge of meal planning and monitoring until their child achieves a healthy weight. This phase typically lasts 3-6 months.
As eating behaviors normalize, age-appropriate autonomy around food is gradually returned to the adolescent. This phase typically lasts 2-4 months.
Once eating is normalized and weight stabilized, therapy addresses broader adolescent development issues. Duration varies based on individual needs.
Because eating disorders affect multiple systems, treatment requires a comprehensive approach. Guidelines recommend multidisciplinary care teams including various specialists 5 .
Physical health monitoring, track vital signs, weight, labs; manage medical complications
Provide therapy (FBT, CBT, DBT); address comorbid conditions
Develop meal plans; normalize eating patterns; nutrition education
Eating disorders in children and adolescents are serious, potentially life-threatening conditions—but they're also treatable. Recovery is always possible with appropriate intervention 1 .
"The important thing to remember is that all eating disorders can be treated and that recovery is always possible" 1 .
Several eating disorder hotlines provide 24/7 support, including:
These services can be accessed immediately over the phone or text, connecting individuals with trained volunteers ready to listen and provide resources.